LAUSR

Annular leukocytoclastic vasculitis (ALV), which was firstly described by Degos and Guiliane [1], is a rare clinical variant of leukocytoclastic vasculitis. It can be accompanied by infections, drugs, and several systemic diseases such as ulcerative colitis (UC) [2-4]. Here, we report a patient with proteinase 3 cytoplasmic-anti-neutrophil cytoplasmic antibody (PR3-ANCA)-positive UC who developed ALV accompanied by pauci-immune glomerulonephritis and haemorrhages of the eyes and palate mucosa. A 28-year-old man with a 10-year history of biopsy-proven UC was referred to our hospital with an acute purpuric rash. He felt general discomfort and abdominal pain. On examination, we observed well-defined annular purpuric lesions on the trunk and proximal extremities. Moreover, there were haemorrhagic lesions in the eyes and palate mucosa (figure 1). There was no evidence of fever or oedema. Routine histology of two skin biopsies revealed small-vessel vasculitis (leukocytoclastic type) with endothelial swelling, extravasation of erythrocytes, and fibrinoid degeneration of the vessel wall, affecting the entire dermis. The cell